title: The impact of a "search and destroy" strategy for the prevention of methicillin-resistant Staphylococcus aureus infections in an inpatient rehabilitation facility.
abstract: OBJECTIVE
  To determine how the implementation of a methicillin-resistant Staphylococcus aureus (MRSA) control program in an inpatient rehabilitation facility (IRF) affects MRSA health care-associated infections (MRSA-HAIs).
  
  
  METHODS
  A retrospective chart review.
  
  
  METHODS
  IRF affiliated with Vidant Medical Center, an 861-bed, acute-care teaching hospital for The Brody School of Medicine at East Carolina University.
  
  
  METHODS
  Seventy-nine adult patients in the IRF who developed a MRSA-HAI from February 2005 through January 2011.
  
  
  METHODS
  Both the acute care hospital and the affiliated inpatient rehabilitation unit began screening 100% of admissions for MRSA nasal carriage, with decolonization of positive carriers, starting in February 2007.
  
  
  METHODS
  Yearly rates of MRSA-HAI per 1000 patient-days were compared in the IRF before and after the intervention.
  
  
  RESULTS
  The weighted mean monthly infection rate before the intervention (February 2005 through January 2007) was 1.0714 per 1000 patient days compared with 0.6557 per 1000 patient days after the intervention (February 2007 through January 2011). The decreased infection rates after the intervention were statistically significant (P = .0315).
  
  
  CONCLUSIONS
  The implementation of an all-admissions MRSA screening program with decolonization of positive carriers in an IRF affiliated with an acute care hospital resulted in decreased MRSA-HAI rates in the IRF. When developing surveillance guidelines for MRSA, IRFs should be cognizant of infection rate trends and of the affiliated hospital's scope of policies and practices for infection prevention and control.
authors.affiliation: Department of Physical Medicine and Rehabilitation, The Brody School of Medicine at East Carolina University, Greenville, NC(∗). Electronic address: aimee.widner@gmail.com.
authors.forename: Aimee
authors.initials: A
authors.lastname: Widner
authors.affiliation: Department of Infection Control, Vidant Medical Center, Greenville, NC(†).
authors.forename: Delores L
authors.initials: DL
authors.lastname: Nobles
authors.affiliation: Department of Physical Medicine and Rehabilitation, The Brody School of Medicine at East Carolina University, Greenville, NC(‡).
authors.forename: Clinton
authors.initials: C
authors.lastname: Faulk
authors.affiliation: Department of Biostatistics, College of Allied Health Sciences, East Carolina University, Greenville, NC(¶).
authors.forename: Paul
authors.initials: P
authors.lastname: Vos
authors.affiliation: Division of Infection Control, The Brody School of Medicine at East Carolina University; and the Department of Infection Control, Vidant Medical Center, Greenville, NC(§).
authors.forename: Keith M
authors.initials: KM
authors.lastname: Ramsey
mesh_terms: D003428:Cross Infection / Q000453:epidemiology / Q000517:prevention & control*; D006801:Humans; D017053:Infection Control / Q000379:methods*; D007297:Inpatients; D008403:Mass Screening; D055624:Methicillin-Resistant Staphylococcus aureus; D009657:North Carolina / Q000453:epidemiology; D012047:Rehabilitation Centers; D012189:Retrospective Studies; D013203:Staphylococcal Infections / Q000453:epidemiology / Q000517:prevention & control*